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Self-government abolished
“Lithuanian health politicians are intensifying the attack, the slander and the denigration of the Lithuanian dental community. Topical problems of oral health and health system,” says Auristida Gerliakienė, Head of the LROR Vilnius Territorial Division.
According to the interlocutor, since the beginning of independence, the institutions that carry out private dental activities in Lithuania do not belong to the Lithuanian National Health System (LNSS), but must meet and comply with the requirements established for this system and its institutions. “LNSS is owned only by state institutions or private dental institutions that have concluded agreements with territorial health insurance funds (ICD). This is only a fifth of all dental institutions: 8% – public institutions and 13% – private institutions They have signed agreements with ICD. According to A.Gerliakienė, private dental establishments with contracts with the ICD are usually dental offices in private family clinics, which are cheaper to rent, maintain, manage, etc.
Lithuanian health policy is intensifying attack, slander and denigration of the Lithuanian dental community.
“So few institutions that have signed contracts with the ICD are due to state policy, and this has been going on for fifteen years, since LROR was established. The state wanted to get rid of the financial and administrative burden, and the House of Dentists. ” Apparently, the Chamber of Dentists has been deprived of state-delegated functions: dentist licenses, etc. This has abolished our self-government. Also, dentists have begun to blame things that have not been done. This area has been said to be opaque. inspections, the Financial Crime Investigation Service (FNTT) and other agencies, “according to the interlocutor, such inspections generally begin in the period before the elections.
Signing contracts is useless
According to A.Gerliakienė, the current system is such that it is not beneficial for private dentists to sign contracts with the ICD. “It’s useless because that contract would slow me down: I couldn’t do some procedures, I couldn’t put a price on them as much as it really costs me to work on this faulty system. The system is distorted by the government’s unwillingness to admit that treatment costs not only the price of materials, but many other things, “said the interlocutor.
A.Gerliakienė compared: if a patient in a public institution or in a private dental office that has a contract with the ICD only pays for dental materials and disposable dental instruments, then in a private dental institution that does not have a contract with the ICD, and for many other things. “Payroll and related taxes, earnings, insurance and other taxes, dental instruments, dental equipment, office furniture and IT equipment, accounting and document management programs, rental of premises, public services, communication services, accounting and elimination of medical waste, local protection, cleaning and other services, administrative costs, all paid by the state at the dental institution belonging to the LNSS, through PSDF or the founder, or paid with EU structural funds. a private institution outside the LNSS, the patient pays for himself. “
He stressed that private medical institutions do not receive charity, nor are EU funds available to purchase equipment. “Everything, including additional training, must be paid for by private dentists and oral care professionals. However, they constantly strive to ensure quality treatment. To meet modern world standards, dentists are forced to apply Hundreds of thousands of loans have been made for decades The salaries and taxes of health care specialists from institutions working at the ICD are covered by the Ministry of Health (SAM) from PSDF funds, various funds from the EU and state support are allocated to these institutions, “says the manager of the LROR Vilnius territorial unit, all this distorts the final cost of services to patients.
Auristida Gerliakienė
Funds – for a small part
According to A.Gerliakienė, it is wrong for state funds for dental care to be distributed annually only to institutions belonging to the LNSS. “The 2018 report of the Territorial Health Insurance Funds clearly states that all public funds for the dental sector (more than 50 million euros) go to only a fifth of dental institutions each year, established by the state o contracted with the ICD. But where did the money go and who was it used? When only 21% of dental institutions are funded, a large part of the Lithuanian population (79%) not only pays the full price of quality dental services, but also pays (in the form of fees) the rest of the population’s dental treatment. “How are the available state financial resources used effectively? It smells like protectionism, “said the LROR representative.
According to the interlocutor, this system is not being changed, although LROR has been making efforts to change it for several years. “Lithuanian health politicians were talked about many times, they were asked to change the price system. However, nothing changes from year to year. This is due to the reluctance to allocate funds to private dental institutions. Apparently, the politicians They have estimated that this would require a large amount of Mandatory Health Insurance Funds (PSDF), so they do not want to approve such a procedure. Politicians only show that they are concerned about oral health problems. But if any problem begins to move, you will not get any solution. Policies increase the high cost of dental services, but no one explains to the public the patient pays in a state or other public institution (polyclinic, primary health care center or other medical institution) and for which you are forced to pay in a private dental institution “, – stated A.Gerliakienė.
Aim for a reasonable price
According to the interlocutor, so far neither SAM, VLK nor the Seimas Health Affairs Committee (SRK) have raised the issue of a fair and cost-based price of dental services, although LROR has long requested them. “Such postponement of the decision, when not all components are included in the price of the dental service, not only creates and maintains tension in the medical community, but negatively affects the timing and quality of treatment,” said the interlocutor.
Why are the LROR proposals not taken into account and the price of dental services paid from the PSDF or otherwise from the state budget not included in all its components? Is it true that all public funds for the dental sector go to only a fifth of all dental establishments each year, private dental establishments established by the state and contracted by the ICD? Who was the 50 million used for? EUR, 2018 for the dental sector as public financing? We send these questions to the SAM Press Office. The Ministry did not respond, forwarded the questions to the State Health Insurance Fund (VLK).
Commentary
State Health Insurance Fund (VLK) under the Ministry of Health
First of all, we would like to point out that VLK implements compulsory health insurance (PSD) in accordance with the procedure established by the legal acts of the Ministry of Health and guarantees the payment of the costs of personal health care of the Mandatory Health Insurance Fund. (PSDF).
Only people insured with PSD are entitled to receive dental services paid for with PSDF funds, as well as other health care services. These services must meet the requirements for the provision of services approved by the Minister of Health and the medical institution must have a contract with the Territorial Health Insurance Fund (ICD) for their provision. In the event that dental services are provided in a medical institution that does not have a contract with the ICD, individuals must pay for the services themselves at the prices established by the institution.
It should also be noted that when dental care services are provided in the institutions of the Lithuanian National Health System, policyholders (except for children and people studying in full-time general education schools, vocational school units full-time until they reach 24 years of age, and socially disadvantaged people when they provide the corresponding certificate from the department of social support of the municipality in whose territory they live) pays for medicines, dental materials and other materials used to provide services dental care, unique measures, taking into account the quantity of materials and equipment used and their purchase prices.
PSDF funds are used to pay for primary personal dental health care, outpatients (dental specialists), day surgery, personal dental inpatient health care, orthodontia, dental prosthetics services. Additionally, institutions providing additional outpatient personal primary health care services are given a supplement for the incentive services provided and good indicators of primary personal dental health care outcomes. 2019 PSDF paid approximately $ 85.7 million for dental services provided. EUR (73.2 million euros in 2018).
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